According to the World Health Organization, about 280 million people worldwide have depression and about one billion have a mental health problem of any kind.

People living in the ancient world also had mental health problems. So, how did they deal with them?

As we’ll see, some of their insights about mental health are still relevant today, even though we might question some of their methods.

1. Our mental state is important

Mental health problems such as depression were familiar to people in the ancient world. Homer, the poet famous for the Iliad and Odyssey who lived around the eighth century BC, apparently died after wasting away from depression.

Already in the late fifth century BC, ancient Greek doctors recognised that our health partly depends on the state of our thoughts.

In the Epidemics, a medical text written in around 400BC, an anonymous doctor wrote that our habits about our thinking (as well as our lifestyle, clothing and housing, physical activity and sex) are the main determinants of our health.

2. Mental health problems can make us ill

Also writing in the Epidemics, an anonymous doctor described one of his patients, Parmeniscus, whose mental state became so bad he grew delirious, and eventually could not speak. He stayed in bed for 14 days before he was cured. We’re not told how.

Later, the famous doctor Galen of Pergamum (129-216AD) observed that people often become sick because of a bad mental state:

It may be that under certain circumstances ‘thinking’ is one of the causes that bring about health or disease because people who get angry about everything and become confused, distressed and frightened for the slightest reason often fall ill for this reason and have a hard time getting over these illnesses.

Galen also described some of his patients who suffered with their mental health, including some who became seriously ill and died. One man had lost money:

He developed a fever that stayed with him for a long time. In his sleep he scolded himself for his loss, regretted it and was agitated until he woke up. While he was awake he continued to waste away from grief. He then became delirious and developed brain fever. He finally fell into a delirium that was obvious from what he said, and he remained in this state until he died.

3. Mental illness can be prevented and treated

In the ancient world, people had many different ways to prevent or treat mental illness.

The philosopher Aristippus, who lived in the fifth century BC, used to advise people to focus on the present to avoid mental disturbance:

concentrate one’s mind on the day, and indeed on that part of the day in which one is acting or thinking. Only the present belongs to us, not the past nor what is anticipated. The former has ceased to exist, and it is uncertain if the latter will exist.

The philosopher Clinias, who lived in the fourth century BC, said that whenever he realised he was becoming angry, he would go and play music on his lyre to calm himself.

Doctors had their own approaches to dealing with mental health problems. Many recommended patients change their lifestyles to adjust their mental states. They advised people to take up a new regime of exercise, adopt a different diet, go travelling by sea, listen to the lectures of philosophers, play games (such as draughts/checkers), and do mental exercises equivalent to the modern crossword or sudoku.

For instance, the physician Caelius Aurelianus (fifth century AD) thought patients suffering from insanity could benefit from a varied diet including fruit and mild wine.

Doctors also advised people to take plant-based medications. For example, the herb hellebore was given to people suffering from paranoia. However, ancient doctors recognised that hellebore could be dangerous as it sometimes induced toxic spasms, killing patients.

Other doctors, such as Galen, had a slightly different view. He believed mental problems were caused by some idea that had taken hold of the mind. He believed mental problems could be cured if this idea was removed from the mind and wrote:

a person whose illness is caused by thinking is only cured by taking care of the false idea that has taken over his mind, not by foods, drinks, [clothing, housing], baths, walking and other such (measures).

Galen thought it was best to deflect his patients’ thoughts away from these false ideas by putting new ideas and emotions in their minds:

I put fear of losing money, political intrigue, drinking poison or other such things in the hearts of others to deflect their thoughts to these things […] In others one should arouse indignation about an injustice, love of rivalry, and the desire to beat others depending on each person’s interest.

4. Addressing mental health needs effort

Generally speaking, the ancients believed keeping our mental state healthy required effort. If we were anxious or angry or despondent, then we needed to do something that brought us the opposite of those emotions.

This can be achieved, they thought, by doing some activity that directly countered the emotions we are experiencing.

For example, Caelius Aurelianus said people suffering from depression should do activities that caused them to laugh and be happy, such as going to see a comedy at the theatre.

However, the ancients did not believe any single activity was enough to make our mental state become healthy. The important thing was to make a wholesale change to one’s way of living and thinking.

When it comes to experiencing mental health problems, we clearly have a lot in common with our ancient ancestors. Much of what they said seems as relevant now as it did 2,000 years ago, even if we use different methods and medicines today.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Konstantine Panegyres, McKenzie Postdoctoral Fellow, researching Greco-Roman antiquity, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Voluntary assisted dying is now lawful in every Australian state and will soon begin in the Australian Capital Territory.

However, it’s illegal to discuss it via telehealth. That means people who live in rural and remote areas, or those who can’t physically go to see a doctor, may not be able to access the scheme.

A federal private members bill, introduced to parliament last week, aims to change this. So what’s proposed and why is it needed?

What’s wrong with the current laws?

Voluntary assisted dying doesn’t meet the definition of suicide under state laws.

But the Commonwealth Criminal Code prohibits the discussion or dissemination of suicide-related material electronically.

This opens doctors to the risk of criminal prosecution if they discuss voluntary assisted dying via telehealth.

Successive Commonwealth attorneys-general have failed to address the conflict between federal and state laws, despite persistent calls from state attorneys-general for necessary clarity.

This eventually led to voluntary assistant dying doctor Nicholas Carr calling on the Federal Court of Australia to resolve this conflict. Carr sought a declaration to exclude voluntary assisted dying from the definition of suicide under the Criminal Code.

In November, the court declared voluntary assisted dying was considered suicide for the purpose of the Criminal Code. This meant doctors across Australia were prohibited from using telehealth services for voluntary assisted dying consultations.

Last week, independent federal MP Kate Chaney introduced a private members bill to create an exemption for voluntary assisted dying by excluding it as suicide for the purpose of the Criminal Code. Here’s why it’s needed.

Not all patients can physically see a doctor

Defining voluntary assisted dying as suicide in the Criminal Code disproportionately impacts people living in regional and remote areas. People in the country rely on the use of “carriage services”, such as phone and video consultations, to avoid travelling long distances to consult their doctor.

Other people with terminal illnesses, whether in regional or urban areas, may be suffering intolerably and unable to physically attend appointments with doctors.

The prohibition against telehealth goes against the principles of voluntary assisted dying, which are to minimise suffering, maximise quality of life and promote autonomy.

Doctors don’t want to be involved in ‘suicide’

Equating voluntary assisted dying with suicide has a direct impact on doctors, who fear criminal prosecution due to the prohibition against using telehealth.

Some doctors may decide not to help patients who choose voluntary assisted dying, leaving patients in a state of limbo.

The number of doctors actively participating in voluntary assisted dying is already low. The majority of doctors are located in metropolitan areas or major regional centres, leaving some locations with very few doctors participating in voluntary assisted dying.

It misclassifies deaths

In state law, people dying under voluntary assisted dying have the cause of their death registered as “the disease, illness or medical condition that was the grounds for a person to access voluntary assisted dying”, while the manner of dying is recorded as voluntary assisted dying.

In contrast, only coroners in each state and territory can make a finding of suicide as a cause of death.

In 2017, voluntary assisted dying was defined in the Coroners Act 2008 (Vic) as not a reportable death, and thus not suicide.

The language of suicide is inappropriate for explaining how people make a decision to die with dignity under the lawful practice of voluntary assisted dying.

There is ongoing taboo and stigma attached to suicide. People who opt for and are lawfully eligible to access voluntary assisted dying should not be tainted with the taboo that currently surrounds suicide.

So what is the solution?

The only way to remedy this problem is for the federal government to create an exemption in the Criminal Code to allow telehealth appointments to discuss voluntary assisted dying.

Chaney’s private member’s bill is yet to be debated in federal parliament.

If it’s unsuccessful, the Commonwealth attorney-general should pass regulations to exempt voluntary assisted dying as suicide.

A cooperative approach to resolve this conflict of laws is necessary to ensure doctors don’t risk prosecution for assisting eligible people to access voluntary assisted dying, regional and remote patients have access to voluntary assisted dying, families don’t suffer consequences for the erroneous classification of voluntary assisted dying as suicide, and people accessing voluntary assisted dying are not shrouded with the taboo of suicide when accessing a lawful practice to die with dignity.

Failure to change this will cause unnecessary suffering for patients and doctors alike.

Michaela Estelle Okninski, Lecturer of Law, University of Adelaide; Marc Trabsky, Associate professor, La Trobe University, and Neera Bhatia, Associate Professor in Law, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.